Hattori Saki, Takahashi Mihoko
Yamanashi Kosei Hospital.
Nihon Koshu Eisei Zasshi. 2011 Oct;58(10):879-94.
To describe the infection prevention and coping behavior for seasonal influenza-like illnesses among hospital nurses.
We conducted an anonymous questionnaire survey of 444 nurses in October 2007, who belonged to two hospitals in one city. We investigated their infection prevention behavior (handwashing, gargling, mask-use, influenza vaccination rate, humidification of the room, room ventilation, increased physical strength) and coping behavior (type of coping, elapsed time until taking appropriate action, absent days, recognition of infection source) in one season, and their characteristics (sex, age, division, family).
423 questionnaires were analyzed. Most nurses performed handwashing with soap or a disinfectant. However, only 71% and 53% of nurses regularly did this after blowing their nose or touching any hair. Many used only water. Only 58% of the nurses gargled at home. Except after handling linen, gargling was done by less than 10%. Regarding handwashing or gargling, nurses who performed these before the beginning of duties or any treatment was only in the range from 10-25% which was less than when they finished their duties or treatment. Handwashing before beginning duties was significantly associated with "living together with a family" (odds ratio [95% confidence interval] after adjusting for sex and age) (0.32[0.12-0.84]) and "living together with children who go to school" (0.49[0.24-0.995]), respectively. Gargling after any treatment and gargling at home, room humidification and ventilation were all significantly associated with "living together with babies and infants" (2.36[1.07-5.21], 1.87[1.07-3.27], 2.29[1.32-3.97] and 2.46[1.39-4.36]). Fifty-five% of the nurses regularly wore masks during work. The influenza vaccination rate was 82%. 67% of 51 nurses who had flu-like symptoms responded appropriately within 24 hours after onset. However, 25% of 51 nurses did not consult a doctor, but instead took over-the-counter medicine or rested at home. Some 28% of 51 nurses did not miss any work days, many not wanting to take time off due to insufficient personnel. 22% of the nurses thus were found to become an infection source. At one hospital, it was more necessary to improve coping behavior, while at another hospital, it was more necessary to improve "handwashing before setting the table" and "gargling after handling linen".
These findings suggest that the infection prevention awareness toward patients was lower than self-infection prevention awareness of nurses and that these were related to such members living together as a family and their place of work. Gargling was not sufficiently performed. These results suggest a need to educate nurses about "coughing etiquette", "handwashing before contacting patients", and "gargling at work and home", and to establish an effective medical protocol where the nurses can consult a medical specialist when they suspect they may have an infection themselves.
描述医院护士针对季节性流感样疾病的感染预防及应对行为。
2007年10月，我们对一座城市两家医院的444名护士进行了匿名问卷调查。我们调查了她们在一个季节中的感染预防行为（洗手、漱口、戴口罩、流感疫苗接种率、房间加湿、房间通风、增强体力）和应对行为（应对类型、采取适当行动前的时间、缺勤天数、感染源认知），以及她们的特征（性别、年龄、科室、家庭情况）。
对423份问卷进行了分析。大多数护士用肥皂或消毒剂洗手。然而，只有71%和53%的护士在擤鼻涕或触摸头发后会经常这样做。许多人只用清水洗手。只有58%的护士在家中漱口。除了处理床单后，漱口的护士不到10%。关于洗手或漱口，在开始工作或任何治疗前进行这些操作的护士仅在10% - 25%的范围内，低于工作或治疗结束时的比例。开始工作前洗手与“与家人同住”（在调整性别和年龄后，优势比[95%置信区间]）（0.32[0.12 - 0.84]）和“与上学的孩子同住”（0.49[0.24 - 0.995]）分别显著相关。任何治疗后漱口、在家中漱口、房间加湿和通风均与“与婴幼儿同住”显著相关（2.36[1.07 - 5.21]，1.87[1.07 - 3.27]，2.29[1.32 - 3.97]和2.46[1.39 - 4.36]）。55%的护士在工作期间经常戴口罩。流感疫苗接种率为82%。51名有流感样症状的护士中，67%在发病后24小时内做出了适当反应。然而，51名护士中有25%没有咨询医生，而是服用非处方药或在家休息。51名护士中约28%没有缺勤，许多人因人员不足而不想请假。结果发现，22%的护士成为了感染源。在一家医院，更有必要改善应对行为，而在另一家医院，则更有必要改善“摆餐具前洗手”和“处理床单后漱口”。
这些发现表明，护士对患者的感染预防意识低于其自身的自我感染预防意识，且这些与家庭成员同住情况及其工作场所有关。漱口操作执行得不够充分。这些结果表明有必要对护士进行“咳嗽礼仪”、“接触患者前洗手”以及“工作和家中漱口”方面的教育，并建立一个有效的医疗方案，使护士在怀疑自己可能感染时能够咨询医学专家。
